管内発育型GISTに対するdouble protector法を用いた胃前壁切開法による単孔式胃内手術の検討

Assessment of intragastric single-port surgery by the double protector method for intraluminal gastric gastrointestinal stromal tumors （GISTs）

◆要旨：【目的】7例の管内発育型GISTに対して，double protector法を用いた単孔式胃内手術を施行し，成績を検討した．【方法】上腹部正中切開をおき，LapShield^®60を挿入し，胃を創直下に誘導する．胃前壁に切開をおき，LapShield^®60を二重に使用し，胃瘻を作製した後，自動縫合器を用い胃内腔から腫瘍を切除し，胃前壁を手縫いで縫合閉鎖した．【結果】手術時間中央値は69分であった．術式の変更は認めなかった．術後合併症は1例も認めなった．全例切除断端陰性で，偽被膜損傷も認めなかった．術後在院日数の中央値は8日であった．【結論】double protector法を用いた単孔式胃内手術は，安全かつ簡便に施行可能であった．

　[Purpose] We performed intragastric single-port surgery by the double-protector method in 7 cases of intraluminal gastric gastrointestinal stromal tumors (GISTs) and assessed the results. [Methods] After making an upper abdominal midline incision, we inserted a LapShield^®60 (LAGIS) and guided the stomach to directly beneath the incision. We incised the anterior wall of the stomach and created a gastrostomy with double LapShield^®60s. We then resected the tumor from the gastric lumen with an automatic stapler, and after manually suturing the anterior wall of the stomach, sutured the wound closed. [Results] Median operation time was 69 min. No changes were noted in the surgical procedure. There were no postoperative complications in any of the cases. The surgical stump margin was negative in every case. No pseudocapsule injuries were observed. Median postoperative hospital length of stay was 8 days. [Conclusion] It was possible to perform intragastric single-port surgery by the double protector method in a safe and convenient manner.